Provider Demographics
NPI:1962503664
Name:MARIKA MOLNAR PHYSICAL THERAPIST PC
Entity Type:Organization
Organization Name:MARIKA MOLNAR PHYSICAL THERAPIST PC
Other - Org Name:WESTSIDE DANCE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-541-8450
Mailing Address - Street 1:53 COLUMBUS AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6909
Mailing Address - Country:US
Mailing Address - Phone:212-541-8450
Mailing Address - Fax:212-541-8582
Practice Address - Street 1:53 COLUMBUS AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6917
Practice Address - Country:US
Practice Address - Phone:212-541-8450
Practice Address - Fax:212-541-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006440-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ3W8H1Medicare ID - Type Unspecified